{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T06:15:51Z","timestamp":1778393751767,"version":"3.51.4"},"reference-count":38,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2010,8,18]],"date-time":"2010-08-18T00:00:00Z","timestamp":1282089600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[2011,4]]},"abstract":"<jats:sec id=\"S0033291710001467_sec_001\"><jats:title>Background<\/jats:title><jats:p>To test whether receiving care from a health visitor (HV) trained in identification and psychological intervention methods prevents depression 6\u201318 months postnatally in women who are not depressed 6 weeks postnatally.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291710001467_sec_a002\"><jats:title>Method<\/jats:title><jats:p>The study was a prospective cluster trial, randomized by GP practice, with follow-up for 18 months in 101 primary care teams in the Trent area of England. The participants were women scoring &lt;12 on the postal Edinburgh Postnatal Depression Scale (EPDS) at 6 weeks postnatally (1474 intervention and 767 control women). Intervention HVs (<jats:italic>n<\/jats:italic>=89, 63 clusters) were trained in identifying depressive symptoms using the EPDS and face-to-face clinical assessment and in providing psychologically orientated sessions based on cognitive behavioral or person-centered principles. The control group comprised HVs (<jats:italic>n<\/jats:italic>=49, 37 clusters) providing care as usual (CAU). The primary outcome measure was the proportion of women scoring \u2a7e12 on the EPDS at 6 months postnatally. Secondary outcomes were mean EPDS score, Clinical Outcomes in Routine Evaluation \u2013 Outcome Measure (CORE-OM) score, State\u2013Trait Anxiety Inventory (STAI), 12-item Short Form Health Survey (SF-12) and Parenting Stress Index Short Form (PSI-SF) scores at 6, 12 and 18 months.<\/jats:p><\/jats:sec><jats:sec id=\"S0033291710001467_sec_a003\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>After adjusting for individual-level covariates, living alone, previous postnatal depression (PND), the presence of one or more adverse life events and the 6-week EPDS score, the odds ratio (OR) for EPDS \u2a7e12 at 6 months was 0.71 [95% confidence interval (CI) 0.53\u20130.97, <jats:italic>p<\/jats:italic>=0.031] for the intervention group (IG) women compared with the control (CAU) group women. Two subgroups were formed by baseline severity: a \u2018subthreshold\u2019 subgroup with a 6-week EPDS score of 6\u201311 (<jats:italic>n<\/jats:italic>=999) and a \u2018lowest severity\u2019 subgroup with a 6-week EPDS score of 0\u20135 (<jats:italic>n<\/jats:italic>=1242). There was no difference in psychological effectiveness by subgroup (interaction term: <jats:italic>z<\/jats:italic>=\u22120.28, <jats:italic>p<\/jats:italic>=0.782).<\/jats:p><\/jats:sec><jats:sec id=\"S0033291710001467_sec_a004\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>This study provides new evidence of a universal, enduring preventive effect for depression in women who screen negative for depression postnatally.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0033291710001467","type":"journal-article","created":{"date-parts":[[2010,8,18]],"date-time":"2010-08-18T03:13:37Z","timestamp":1282101217000},"page":"739-748","source":"Crossref","is-referenced-by-count":94,"title":["Universal prevention of depression in women postnatally: cluster randomized trial evidence in primary care"],"prefix":"10.1017","volume":"41","author":[{"given":"T. S.","family":"Brugha","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. 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